Medical syringe and process



Sept. 26, 1950 N. STEINBERG MEDICAL SYRINGE AND PROCESS 2 Sheets-Sheet 1 Filed Dec. 11, 1947 ATTORNEYS.

Sept. 26, 1950 N. STEINBERG 2,523,850

MEDICAL SYRINGE AND PROCESS Filed Dec. 11, 1947 2 Sheets-Sheet 2 Patented Sept. 26, 1950 UNITED STATES PATENT 'OFFECE 2,523,850 MEDICAL SYRINGE AND PROCESS Nathan Steinberg, Fhiladelphia, Pa. Application December 11, 19 17, S r ial No. 791,009

The present invention relates to medical syringes and processes of medication.

A purpose of my invention is'to permit the injection of medicaments into the body of apatient by a layman, who may be the patient himself or a non-medically trained person caring for the patient.

A further purpose is to administer medicaments subcutaneously or intravenously into the body of a patient at frequent intervals Without the necessity of hospitalization.

A further purpose is to permit an ambulator patient to take an extensive course in hypodermic medication.

A further purpose is to .permitsuccessive hypodermic injections over aperiod of time without the necessity of subsequent punctures from a hypodermic needle. V

A further purpose is to reduce the danger of breaking on a hypodermic needle in the body of the patient.

A further purpose is to permit the injection of medicaments while the patient is asleep without disturbing the patient.

A further purpose is to mount a hypodermic syringe semipermanently from-acarrier attached to the body of a patient and to administe a succession of doses from the syringe through a hypodermic needle applied in the same puncture in the body of the patient.

A further purpose is. to provide an es'capement lever, which limits a rack in stepby step motion 7 of a syringe plunger in a barrel, anddesirably to mount the ack on a sandwich clamp bracket from the barrel. l i l 5 A further purpose is to provide a quick release of the rack from the plunger.

A further purpose is to holdthe es'capement lever at each end of the stroke by a detent;

A further purpose is-to provide "a U-shaped or forked'carrier whichhas hooked ends intercone necting with the bracket and which has a yoke bridging the opposite end oi the barrel of the syringe.

Further purposes appear and in the claims.

In the drawings'l have chosen to illustrate one onlyof the embodiments in whichmy invention may appear, choosing the form shown from the standpoints of simplicityin"illustration; satisfactory operation'andclear demonstration of the Figure 2 isa view corresponding toFigure 1 in the specification 14 Claims. (01. 128-215) it"? any character which will be injected hypodermir 2 showing thefsyringe mounted on the carrier and the hypodermic needle inserted in the body of the patient. v

Figure 3 is a perspective of the carrier alone. Figure 4 a fragmentary perspective of the syringe mounted in the carrier.

Figure 5 is a perspective of the syringe alone, without the hypodermic needle.

Figure 6 is an exploded perspective of the plunger and barrel separated from the remaining sandwich clamp bracket and rack.

Figure 9' is a perspective of the escapement lever.

Figure 10 is an enlarged longitudinal sectionof the connection between the rack and the mount.

, of the patient at frequent intervals. While the invention may in some cases be applicable to the treatment of animals generally, itisan'ti'cipated that the invention will find its chief use in the treatment of humans, and accordingly the patient will be considered generally as a human being, although the invention will also be applicable in some cases to the treatment of, or the medical experimentation upon, animals other than humans. M

While the medicament employed may be of cally, it is'believed that the widest applicationof the invention will be in administering antibiotics such as aqueous penicillin, streptomycin and the like. Extensive use is being made'of such me' dicaments employing frequent injections in the treatment of tuberculosis, syphilis and other dis eases. Such treatments must frequently be administered to patients who cannot be hospitalized byreason'of their prejudice against hospitalization', unavailability of hospital space, insufficient income of the patient to pay for hospitalization or the like, and the requirement of hospitalization hasbeen-a limiting factor which has retarded the more extensive use of such treatment.

One of the primary purposes of the present invention is to permit the administration of medicaments, especially antibiotics such as penicillin and streptomycin, to a patient who is not hospitalized, by a person such as the patient himself or his friends or relatives and who is without medical training and could not safely make a puncture with a hypodermic needle.

At the same time I seek to permit the patient, in many cases, to remain ambulatory and to administer the repeated injections while going about his affairs.

It is also intended to overcome the difiiculty which is encountered with some patients through objection to the pain or" puncturing and through increased objection because of soreness of a local area when repeated punctures must be made in such area.

At the same time it is possible to avoid the difficulty of breaking off the hypodermic needle which occurs whenever very frequent injections are made, and to avoid the danger to the surgeon of exposing his body to X-rays while operating to remove a broken needle under the fluoroscope. I also desire to permit administration of an injection to a sleeping patient without disturbing the patient in some cases.

In accordance with the invention, after the hypodermic syringe is filled with a sufficient quantity of medicament for several doses, the hypodermic needle is inserted into the body of the patient and the syringe is affixed to the patients body so that repeated doses can be injected through the same puncture of the hypodermic needle. 7

The mounting of the syringe on the body of the patient is preferably accomplished by a carrier suitably fastened to the body. The dosage is preferably automatically limited by step by step mechanism which permits injection of one dose at a time reliably without special attention by the person administerin it.

As seen in Figure 1, a suitable location on the body is selected for the injection, such as the thigh 25, to which a carrier 2| is secured by any suitable means. While a belt, bandageor the like may be employed, it is preferred to use adhesive tape 22 for attachment of the carrier to the body. The adhesive tape is preferably carried across prongs 23 and 24 of the forked carrier which has hooks 25 and 26 at one end for engagement with the syringe at its back portion and a yoke 27! to straddle the forward portion of the syringe barrel. This latter feature is best seen in Figure 2.

It will be evident that the carrier 2| can be put in place before the syringe is applied, and can be left in place when the syringe is removed for any purpose, unless it is desired to move the carrier to relocate the puncture.

The syringe maybe of anysuitable type, conveniently consisting of a barrel 28 having an interior cylinder 29 connecting to a tubular discharge fitting 35 which receives the hub 31 of a hypodermic needle 32 bent at 33 and inserted into the body of the patient at 34. At the end of the barrel at which the cylinder 29 opens, the barrel is flanged to form a head 35. The cylinder 29 receives a cooperating plunger 36 which at the opposite end carries a head 31. The plunger and cylinder may be of any suitable material, consisting-for example of glas. plastic or the like. i

A bracket 38 of metal or the like surrounds and is fastened on the head 35 of the barrel. The

bracket is preferably in the form of a sandwich clamp, comprising a base 39 recessed at 40 near the center to pass the outside of cylinder portion M of the barrel and having opposite wing projections 62 and 43 .projecting from the base. At preferably diametrically opposite positions from the wing projections, shoulders "54 and 45 parallel to one another extend in the direction of the axis of the hole 40 to engage against flats AS on the head 35 and prevent rotation of the barrel. The shoulder 44 also carries guides 4'1 and G8 which with the shoulder provide a key slot 39 in the direction of the axis of the hole 40.

The win 42 carries a pivot 50 which provides pivotal connection to a spring top 5i on the bracket, which spring top is capable of flexing to bring pressure on the head 35 of the barrel and is locked by a recess 52 in a wing 53 opposite to a, wing 54 which turns in the pivot 50. The recess 52 makes connection in closed position beneath a locking head 55 on the wing 43 of the base. Thus when the barrel is inserted in the hole 40 of the base and the top 5! is pivoted and locked to engage the top of the head 35 of the barrel, the barrel and bracket are locked together as shown in Figures 4 and 5 both from the standpoint of longitudinal motion and r0- tation, but they can be readily separated by simply unclamping the connection at 52 and 55 and swinging to the position of Figure 8. A hole 55 is provided in the top 5i to allow the plunger 36 to pass through into the cylinder.

A sandwich clamp mount 5'! is provided on the plunger, engaging its head. This mount, as seen in Figure 7, consists of a metallic base 58 having a, socket portion 59 engaging a ball portion 66 on the plunger head 31 and provided with a hole 6| for insertion and removal of the plunger. Wings 62, 63 and 64 are provided extending radially from the base, preferably at 90 intervals around the base.

A spring metal top 65 of the mount has corresponding wings 66, 61 and 68 as well as a central gripping portion 69. The wing 65 on the top is pivotally connected at T0 with the wing 62 on the base and the Win 68 on the top has a locking recess H for engagement under a locking head 12 on the wing 64 on the base. The wing 63 on the base is slotted at one side at 13 and the corresponding wing 61 on the top is slotted at the corresponding side at 14.

A rack '35 having ratchet teeth 15 facing (having their stop portions facing) in the forward direction with respect to the plunger makes a quick release connection ll with the mount by engaging in the slots l3 and M, thus also looking together the base and top of the mount in the closed position shown in Figure 5 to grip the head of the plunger. The quick-release connection is conveniently formed by a screw 18 threaded. into the rack 75 at T9; and having a circular seat nut 89 threaded thereon, and en gaging in circular recesses 81 in the slots 13 and H of the wings. A nut 82 holds the wings in place, and a stop 18 prevents inadvertent removal of the nut 82.

The rack extends to a position beyond the bracket in the outermost position of the plunger. The rack passes through the guiding keyway 49 of the bracket for control. of the forward motion. An escapement lever 83 is pivoted preferably near its middle at 8 1 from opposite walls 85 and 8G forming parts of the guides 41 and 48. The escapement lever has tripping handles 81 and 8% at its opposite ends to permit'movement back and forthbetwen items limiting positionsand has on each sidebfthe-pivot and equidistane from thepivot anescaperhenttooth 89, 90 011'- posed to'and cooperating with the rack' for escapementpurposes: Deten't recesses SI and 92" on the escapenientlever are engage'd inth twolimiting positions alternatively by"adetentplung-v er93exte'nding' in a hole"throug'h"the wall 86 i and beyond the same for engagement with a leaf spring Mfmounted by a screwtfi. The leaf spri'r1g94 "can be rocked'to the side for purposes of'disassembl'y of the detent, as shown in Figure 8.

The"escapement lever teeth" 89- and Bib-are spaced"from "one another by "a distance which inolu'd'es'an; integer plus a' fraction; of the tooth space of "the rack, for'eXaniple-oneand threeeighths", one and one-half) oneand five eighths, two and three eig'hths, two' and one-half, two and five-eighths, three and one-fourth, etc; times the tooth spacing. Thus" in a given position in which the handle 81 is depressed", as shown in Figure "11, the rackwill advance until the escapement tooth 89"engages the next tooth on the rack; at which point the rack will stop as in Figure 12. The rack and plunger cannotfurther advance until the escapement is shifted by depressing the'handle 88, at'which'point the escapement tooth 89 releases its engagement with the raoktooth as shown in'Figure 12 and the escapement tooth 9e engages in'front of another rack tooth permitting'the rack to advance onehalfa'tooth'distance. Thus in the form illustrated each step is one-half times tooth distance, and the dose will be a corresponding volume, say' one-half cubic centimeter, onthe syringe.

Inthe preferred embodiment as shown, the escapement tooth spacing "is one and one-half times the rack tooth spacing, and thereby rack andplunger advance one-half rack'tooth spacing distance for each shift of the escapement lever.

The reverse faces of the rack teeth and the' escapement teeth have cooperating cam faces 96 and 9?. which automatically shift the escapement lever back and forth to permit withdrawal of the rack and plunger without pressing the escapeme'nt lever" by hand. Thisipermits' quick withdrawal of the plunger for the purposeof refilling. 7 r

At the outward limit of motionof therack the rack may be'prevented from completewithdraw'al by means of a stop98 at the end of the rack.

which 'the needle is rcrcewmtothe body ofthe patient. The needle, as well known; is fastened on theforward end-of the barrel of the syringe In operationthe glass p arts of the syringe may be conveniently removed from the metal partsas shown in-Figures 6to 8, inclusive, and the various parts, particularly the glass parts, sterilized. The

needle thrughthe-woke 'of the eather,- after and isconve'niently bent at an angle} preferably somewhat less than a right "angle so that it will extend transverselyinto the ibody of the patient." The bracket of 'thesyringe provided "at each side with" sockets or'recesses'99 "and itii'between the baseuahd top wingsofthe br'acketand on either side of the syringe barreL' The rear of the syringe is 'then brought down against the" bodyand thecarrier is forced'up-so=that the hook ends 25 "and-26 at the rearward'e'nd of the carrier are receivedin the sockets of th'br'a'cket, hooked over the wings 42 and-43.

The syringe is now in its outermost operating I position-and the user oan apply thefirs't' dos'e by pressing forward on the rear ofthe plunger.

If the-barrel advancesya dose corresponding for example to cc. willbe administered) If the syringe does not advance thefusei shifts' the 1 escapement lever to its "opposite position and again presses on the rear of the-plunger'to advance-the syringe one half tooth distance which corresponds to onedose:

The equipment is then allowed to remain in its position until time for thenext dose, the patient again tries the forward pressure on the plunger, and'if the plunger moves forward he canadmini'ster a dose indicating" thatthe escapement lever has been inadvertently rocked during the period'between doses; If, howevehthe plunger does not move forward the escapement leveris then shifted and the plunger carried forward to applythe dose. I

This procedure is continued until the syringe V has been exhaustedor the time arrives for the refilling of the syringe, atwhich'time the syringe ,7 may' be replaced or "refilled in any suitable manner. I I

To remove the syringe from the carrier, the

hooked ends of the carrier are removed from the sockets .of the syringe, the hypodermic needle removed from the body and the forward end of the syringe withdrawn from the yoke. The carrier can be left in place to receive the replacement special techniques may be used to refill the syringe without removing the needle from the puncture.

To disassemble the syringe once it has been taken away from-the patient', thequickrelease syringe will then be reassembled using sterile technique as well-known; The various parts and filled with a suitable subcutaneous or intravenous niedioarnent for example an antibiotic such as" penicillin or streptomycinina suitable quantity.=

Fer" example the complete daily' dosage of the antibioticmay be placed in the'syringe at one time,= con'taining for instance two hundred thou sa'ndtoonemillion units of penicillin. Convenien t sizcstor the syringe may be 5 00.;6 cc. and '12'; eel- "syringe isthen inserted inthe' forward end of the carrier by 'pas'sing thehypc derinic at- 'il between the rack'and the mount is loosened and the top of the mount is turned to the positionj of Figure 7, releasing the mount from the head}- on the end of the plunger. The whole'inountis ,turnedto disengage the mount completely from therac'k. The plungerfis then withdrawn, after which the mount can be slid off the plunger. The screw --'.'I8"can then, if'desired, be removed from the end of the rack, first loosening the seat nut' 8 B,-"andthe rack can thenjif desired, be taken outof the guideways of thebracket. The bracket is-separated from the head ofthe barrel by turning the spring top of the bracket away fromthe shoulder Mi (which acts as a stop, over the shoul der'45-which'acts as a detent)-to the position of Figure 8 and'slidingthe barrel out of the bracket; The reverse procedure can-befollowedin"reas semb ly.' I

If the glass or plastic barrel or plungerbreak',

it fcainreadily be replaced when the parts are' dis assembled:

The invention has been applied experimentally to administer antibiotics subcutaneously or intravenously to more than seventy patients who in each case continued the administration of the doses themselves or by aid of non-medically trained friends. Only two of these patients refused further treatment by the same method after the first twenty-four hours. Two of the patients were blind and applied the successive doses entirely by feel. Several of the patients were unable to understand the English language and were instructed in the application of the dosesby sign language. A substantial number of the patients were of low intelligence, but they were able to carry on the simple operations required. A number of the patients remained ambulatory, one did housework for hire, one attended the movies for pleasure and most of the patients got in and out of bed frequently during the treatment without difficulty through breakage of syringes or hypodermic needles, or interruption of treatment.

Several of the patients who were unable to stand the pain of frequent punctures with the hypodermic needle were enabled to undergo the treatment because the punctures were limited to one each day or each twelve hour period. The experiments have indicated that the invention is of considerable benefit in combating the inroads of tuberculosis and syphilis particularly among persons of low incomeand persons having highly developed prejudices against hospitalization.

In view of my invention and disclosure variations and modifications to meet individual whim or particular need will doubtless become evident to others skilled in the art, to obtain all or part of the benefits of my invention without copying the process and structure shown, and I, therefore, claim all such insofar as they fall within the reasonable spirit and scope of 'my claims.

Having thus described my invention, what I claim as new and desire to secure by Letters Patent is: p

1. Ina syringe for use onthe body of a patient, a barrel, a plunger cooperating with the barrel, a bracket secured to the barrel adjacent the end at which the plunger enters and including a socket and a carrier engaging in the socket and also engaging the opposite end of the barrel to support the syringe from the'body and extending longitudinally of the barrel in spaced relation in position to support the barrel against the body. 1 1

2. In a syringe for use on the body of the patient, a barrel, a plunger extending into the barrel and cooperating therewith, a bracket mounted at the end of the barrel at which the plunger enters and a forked carrier having a yoke portion which extends over the forward end of the barrel and an interconnecting portion which engages the bracket at the rearward end of the barrel, the carrier being adapted to be mounted on the body of the patient.

3. Ina syringe, a barrel, a plunger entering the barrel and cooperating therewith, a bracket,

fiQ-wich clamp bracket and the sandwich clamp a quick removable mounting for the bracket on ing the barrel, a bracket mounted on the barrel at the end at which the plunger enters, a carrier extending longitudinally of the barrel and having sides spaced laterally for mounting on the body of the patient interconnecting with the bracket to hold the barrel, and step by step mechanism limiting the advance of the plunger to a single step at a time corresponding to a particular dosage.

5. In a syringe, a barrel, a plunger cooperating with the barrel and entering the same at one end of the barrel, a bracket mounted on the barrel, a rack mounted on the plunger at the end opposite to that which enters the barrel and extending generally parallel to the barrel and an escapement lever pivoted on the bracket and having a plurality of oppositely disposed teeth one of which is successively in the path of the rack to limit the advance of the rack to not in excess of a half tooth distance at each step of the rack.

6. In a syringe for use on the body of a patient, a barrel, a plunger cooperating with and entering the barrel, a bracket surrounding and engaging the end of the barrel at which the plunger enters and having sockets on either side thereof, a rack removably attached to the rear end of the plunger and extending parallel to the barrel, a carrier having prongs which engage in the sockets and adapted to hold the barrel against the body of the patient and an escapement lever pivoted on the bracket extending in cooperative relation with and in the direction of the rack and having a pair of spaced teeth one of which is always in engagement with the rack and at different positions with respect to the approaching teeth of the rack so as to limit the advance of the rack one-half tooth distance in either position of the escapement lever.

'7. In a syringe for application of doses to a patient, a barrel having a head at an open end thereof and a hypodermic needle connection at the opposite end, a sandwich clamp bracket sur- "plunger having a head at the end remote from the barrel, a sandwich clamp mount surrounding the end of the head on the plunger, and step by step mechanism interconnecting the sandmount to limit the advance of the plunger at a given step to a single dose. 7

8. In a syringe, a barrel having a head at an open end thereof and a hypodermic needle con- .nection at the opposite end, a sandwich clamp bracket surrounding and engaging the head and having an opening in line with the interior of the barrel, a plunger extending through the opening of the sandwich clamp bracket and into the barrel, the plunger having a head at the end remote from the barrel, a sandwich clamp mount surrounding the head on the plunger, a rack secured at one end to the mount and extending toward and beyond'the bracket, a guide on the bracket engaging the rack and an escapement lever pivoted on the bracket and limiting the rack to a predetermined tooth advance at any position of the escapement lever.

9. In a syringe, a barrel having a head at an open end thereof and a hypodermi needle connection at the opposite end, a sandwich clamp bracket surrounding and engaging the head and having an opening in line with the interior of the barrel, a plunger having-a head at the rear end and extending through the opening of the sand- 9 wich clamp bracket and into the barrel, a sandwich clampmount surrounding the head end of the plunger, a rack extending from the mount to and beyond the bracket, a removable connection between the rack and the mount, a guide on the bracket for the rack and an escapement lever pivoted intermediate its ends on the bracket and having a pair of teeth cooperating with the teeth on the rack and located one on each side of the pivot, only one tooth of the escapement lever being in the path of the rack at a given position of the escapement lever.

10. In a syringe, a barrel having a head at an open end thereof and a hypodermic needle connection at the opposite end, a sandwich clamp bracket surrounding and engaging the head and having an opening in line with the interior of the barrel, a plunger having a head at the rear end and forwardly extending through the opening of the sandwich clamp bracket and into the barrel, a sandwich clamp mount surrounding the head end of the plunger, a rack supported at one end and extending from the mount to and beyond the bracket, a removable connection between the rack and the support, a guide on the bracket for the rack and an escapement lever pivoted intermediate its ends on the bracket and having a pair of teeth 1 cooperating with the teeth on the rack and located one on each side of the pivot, the pivot being located so that only one tooth is in the path of the rack at a given position of the escapement lever, and a detent on the bracket which engages the lever in its two opposite positions and retards the lever in its initial motion in the opposite direction.

11. In a syringe for application of doses to a patient, a barrel having a head at an open end thereof provided with a flattened portion at one side of the head and having a hypodermic needle connection at the opposite end, a sandwich clamp bracket surrounding the head having an opening in line with the interior of the barrel and having a gripping wall which engages the fiattened portion and prevents turning of the barrel with respect to the clamp, a plunger having a headat the rear end and forwardly-extending through the opening of the sandwich clamp bracket and into the barrel, a sandwich clamp mount surrounding the head end of the plunger, a rack supported at one end and extending from the mount to and beyond the bracket, a guide on the bracket for the rack, and escapement means on the bracket for releasing the rack step by step to permit administering successive doses.

12. In a syringe, a barrel having a hypodermic connection at one end, a, plunger cooperating with and extending into the barrel, a bracket mounted on the barrel, a mount secured upon the plunger and step by step release means interposed between the bracket and the mount including a rack having uniformly spaced teeth and an escapement lever having a pair of spaced i0 escapement teeth alternatively in engagement with the rack, spaced by .a distance which is an integer plus a fraction times the rack tooth spacing and further including a pivot for the escapement lever positioned equidistant between the escapement teeth.

13. In a syringe, a barrel having a head at one end and a hypodermic needle connection at the opposite end, a sandwich clamp bracket surrounding and engaging the head and having an opening in line with the interior of the barrel, a plunger extending through the opening of the sandwich clamp bracket and into the barrel, the

plunger having a head remote from the barrel, a

the escapement teeth being an integer plus a fraction times the rack tooth spacing.

14. In a syringe, a barrel having a hypodermic needle connection at one end, a bracket supported on the barrel, a plunger extending into the barrel, a mount secured on the rear end of the plunger, a rack secured at one end to the mount and extending toward and beyond the bracket, the rack having ratchet teeth which provide stop engagement on the forward side and have cam reverse faces, a guide on the bracket engaging the rack and an escapement lever pivoted intermediate its ends and having escapement teeth equidistant from the pivot alternatively cooperating with the rack, having stop faces opposed to the forward faces of the rack teeth and having reverse cam faces opposed to the cam faces on the rack teeth, whereby on reverse motion of the rack the escapement lever will swing back and forth under the action of the cams and release the rack without hand application to the escapement lever itself.

NATHAN STEINBERG.

REFERENCES CITED The following references are of record in the file of this patent:

UNITED STATES PATENTS Number Name Date 2,008,340 Salvati et al. July 16, 1935 2,101,140 I-Iege Dec. 7, 1937 2,103,174 Posada Dec. 21, 1937 2,150,738 Dunajeff Mar. 14, 1939 2,316,095 Mead, Jr. Apr. 6, 1943 2,409,656 Austin Oct. 22, 1946 2,457,859 Austin Jan. 4, 1949 FOREIGN PATENTS Number Country Date 757,501 France Dec. 28, 1933 

